Healthcare Provider Details

I. General information

NPI: 1659787638
Provider Name (Legal Business Name): ELLEN SARAH HUFFMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLEN SARAH RAMSETH LPN

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 07/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 1ST AVE SW
AUSTIN MN
55912-2504
US

IV. Provider business mailing address

2980 RICE ST
LITTLE CANADA MN
55113-2230
US

V. Phone/Fax

Practice location:
  • Phone: 507-434-4900
  • Fax: 507-434-4919
Mailing address:
  • Phone: 651-488-4655
  • Fax: 651-488-4656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberR221235-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: